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Z D Mulla

Publications and source records attributed to Z D Mulla.

8 recordsLinked to original sources
PubMed2006

Correlates of length of stay, cost of care, and mortality among patients hospitalized for necrotizing fasciitis.

Several previous studies of necrotizing fasciitis (NF) have been single-institution investigations suffering from small samples sizes. This study of 216 NF patients hospitalized in Florida, USA, during 2001 was designed to identify risk factors for length of stay (LOS), total patient charges (TC), and mortality, using a statewide database. Robust gamma mixed regression was used to determine the predictors of LOS and TC while simultaneously accounting for outliers and the clustering of patients in 87 hospitals. Relative risks (RR) for hospital mortality were calculated using binomial regression. The NF hospitalization rate in Florida was 1.3/100,000. The median TC was US$54,533 and cumulative charges for all 216 patients were nearly US$20 million. Patients aged > or =44 years at the time of admission were five times as likely to expire in the hospital than patients who were aged < or =43 years (adjusted RR 5.08, P=0.03). Unexpectedly, diabetes was associated with a 61% reduction in the risk of hospital mortality (adjusted RR 0.39, P=0.04). Age > or =44 years was the most powerful predictor of prolonged LOS, elevated TC, and an increased risk of hospital mortality in patients suffering from NF.

Adult↗
PubMed2000

Primary malignancies of the thyroid: epidemiologic analysis of the Florida Cancer Data System registry.

PURPOSE: Descriptive epidemiology of thyroid cancer in Florida. METHODS: The Florida Cancer Data System (FCDS) registry was used to identify patients with the different histologic subtypes of thyroid cancer occurring in Florida from 1981 through 1993. RESULTS: The FCDS recorded 5746 primary malignancies of the thyroid. The average annual incidence of all types of thyroid cancer was 37.0 cases/1,000,000 population. One type of thyroid cancer (papillary carcinoma) accounted for the overall increase during the 13 years of this study. There was no difference in incidence based on Hispanic ethnicity, but the incidence in Blacks was half that of Whites, and Blacks showed less advanced disease at the time of diagnosis. CONCLUSIONS: The increase in incidence of only one histologic type of thyroid cancer suggests that the increasing rate is not an artifact related to the utilization of new diagnostic technologies. The lower incidence and tendency to have less advanced thyroid cancer in Blacks would indicate that racial differences in thyroid cancer are not likely explained by socioeconomic factors such as access to medical care. A substantial amount of the difference in incidence between Whites and Blacks is explained by differences in age distribution.

Adult↗
PubMed1998

Malignant tumors of the eyelid: a population-based study of non-basal cell and non-squamous cell malignant neoplasms.

OBJECTIVE: To determine the relative frequencies, average annual incidences, and patient characteristics of non-basal cell and non-squamous cell malignant neoplasms of the eyelid in a defined geographic population. DESIGN AND SETTING: A retrospective study using the Florida Cancer Data System to identify malignant tumors of the eyelid, except for basal cell and squamous cell carcinomas, from 1981 through 1994. Cases were limited to persons who resided within Florida. MAIN OUTCOME MEASURE: Incidence of histologically confirmed malignant eyelid tumors. RESULTS: Two hundred six primary malignant eyelid tumors were identified. The 3 most common, in order of frequency, were melanoma, sebaceous carcinoma, and lymphoma. The median age at diagnosis for all patients was 73 years. Only 3 of the 206 malignant neoplasms occurred in blacks. The annual incidence of eyelid melanoma and sebaceous carcinoma in whites older than 20 years was 0.6 and 0.5 per million, respectively. Kaposi sarcoma was the most common type of mesenchymal tumor. Eleven different histologic types of lymphoma were found in the eyelid. Only 2 of 27 lymphomas had T-cell lineage. CONCLUSIONS: Malignant tumors of the eyelid other than basal cell and squamous cell carcinoma are uncommon and usually occur in elderly white persons. Primary eyelid tumors of any type are rare in blacks. The risk of a non-basal cell and non-squamous cell malignant neoplasm of the eyelid in Florida is 6.4 times greater for whites than for blacks (95% confidence interval [CI], 2.1-20.2). A variety of B-cell lymphomas can be manifested as primary eyelid tumors.

Adenocarcinoma, Sebaceous↗
PubMed1998

Malignant tumors of the orbit. Analysis of the Florida Cancer Registry.

PURPOSE: The purpose of the study is to determine the relative frequency and incidence of primary malignant tumors of the orbit occurring in Florida. METHODS: Cases of primary orbital malignancy were identified in the Florida Cancer Data System registry from 1981 through 1993. Analysis was restricted to persons who reside within the state. RESULTS: Three hundred fourteen primary orbital malignancies were reported; 55% of malignant orbital tumors were lymphoma. The average annual incidence for all malignancies was 2 cases per million. There was a steady increase in the annual incidence of orbital malignancy during the 13 years of the study. Lymphoma showed the greatest rise in annual incidence. The average annual incidence of lymphoma increased 166% the last 6 years of the study compared to the first 6 years. CONCLUSIONS: A large increase in orbital lymphoma was documented in the Florida cancer registry from 1981 through 1993. The increase in incidence cannot be explained by improved compliance in reporting or by the small increase in incidence of systemic lymphoma during the survey period. Additional studies are needed to determine whether the observed increase in incidence in orbital lymphoma is genuine or spurious.

Adolescent↗